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how should we define health?
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most recent definition is a state of physical, mental, and social well-being in which disease and infirmity are absent
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1900s definition of health
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health as a lack of impairment of everyday activities
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1930s definition of health
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health as absence of disease
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1948 definition of health
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state of complete physical, mental, and social wellbeing and not merely absence of disease or infirmity
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2009 definition of health
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health as adaptation not fixed entity
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global health
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The health of populations in a worldwide context that go beyond the perspectives and concerns of individual countries. Global health is about an international collaborative approach to achieving equity in health for all people worldwide.
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international health
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the study of health issues that affect people living in the developing world
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book of leviticus
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oldest set of health guidelines
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hammurabis code
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oldest set of health laws
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how has public health changed over time?
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community sanitation w greek toilets, industrial revolution brings smell bad=be bad, germ theory
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germ theory
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john snow, cholera found from polluted water in communal pump
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life expectancy
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The average number of years an individual can be expected to live, given current social, economic, and medical conditions. Life expectancy at birth is the average number of years a newborn infant can expect to live.
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Epidemiologic Transition
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shift from infectious/acute disease to chronic disease
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nutrition transition
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shift from under nutrition to over nutrition
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demographic transition
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shift towards lower birth and death rates
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fertility transition
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reduction of birth rates
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Prevention and Promotion risk factors
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an exposure or characteristic that increases the likelihood of developing a particular disease
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factors needed for causation
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1) Strong Association (exposure tied to disease)
2) Temporal Sequence (exposed and got sick, time)
3) Dose-effect Response (more you're exposed=greater the risk)
4) Absence factor (absence of disease)
5) Other considerations/populations (other vectors, evaluated multiple populations)
2) Temporal Sequence (exposed and got sick, time)
3) Dose-effect Response (more you're exposed=greater the risk)
4) Absence factor (absence of disease)
5) Other considerations/populations (other vectors, evaluated multiple populations)
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unmodifiable risk factors
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age, ethnicity, and genetic markers for certain diseases (mother to child spread of hiv)
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Modifiable risk factors
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Factors contributing to the development of a noncommunicable disease that can be altered by modifying one's behavior or environment (unprotected sex transmittance of hiv)
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Levels of Prevention
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Primary: prevent/promotion Secondary: screen-early detection Tertiary: treat- to prevent further deterioration, rehab
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Millennium Development Goals (MDGs)
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eight goals adopted by the UN to address inequity in the international system with the objective to improve people's lives globally by 2015; developing countries
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MDGs
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1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
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Sustainable Development Goals
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Seventeen goals adopted by the U.N. in 2015 to reduce disparities between developed and developing countries by 2030.
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SDGs
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1. No poverty
2. Zero hunger
3. Good health and wellbeing
4. Quality education
5. Gender equality
6. Clean water and sanitation
8. Decent work and economic growth
16. Peace, justice and strong institutions
2. Zero hunger
3. Good health and wellbeing
4. Quality education
5. Gender equality
6. Clean water and sanitation
8. Decent work and economic growth
16. Peace, justice and strong institutions
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important epidemiological measures
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birth, death rates, mortality, morbidity rates, disability, risk factor rates
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demography
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study of size and composition of human populations
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birth rates
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births per year per 1000 people in the total population
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death rates
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deaths per year per 1000 people in total population
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dependency ratio
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The number of people under age 15 and over age 64 compared to the number of people active in the labor force
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morbidity
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the state of being diseased or unhealthy within population
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healthy life expectancy
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the number of years the average person born into a population can expect to live without disability
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incidence
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new cases of disease
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prevalence
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total cases of disease
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Burden of Disease
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an estimate of the impact of disease, disability and premature death on a population
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Disability Adjusted Life Year (DALY)
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A measure of burden of disease, one DALY equals one year of healthy life lost due to premature death and time lived with illness, disease or injury.
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social determinants of health
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SES conditions that influence health status and access to health services
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PROGRESS PLUS
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1) Place of residence (rural/urban; particular state or province; housing characteristics)
2) Ethnicity
3) Occupation (employment status)
4) Gender (male/female/other)
5) Religion
6) Education
7) Social Capital (neighborhood, community and family support)
8) Socioeconomic position (income, wealth, and other measures)
9) PLUS Age, Disability, Sexual Orientation, Other vulnerable groups
2) Ethnicity
3) Occupation (employment status)
4) Gender (male/female/other)
5) Religion
6) Education
7) Social Capital (neighborhood, community and family support)
8) Socioeconomic position (income, wealth, and other measures)
9) PLUS Age, Disability, Sexual Orientation, Other vulnerable groups
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GDP
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Gross Domestic Product- the total market value of all final goods and services produced annually in an economy
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Gross National Product
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The total value of goods and services, including income received from abroad, produced by the residents of a country within a specific time period, usually one year.
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Gross National Income (GNI)
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The value of the output of goods and services produced in a country in a year, including money that leaves and enters the country
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Purchasing Power Parity (PPP)
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The amount of money needed in one country to purchase the same goods and services in another country
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health inequality
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differences in health experience and health status
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health inequity
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health differences that are a function of social, political, and economic environments
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Gidden's Runaway World
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economic structure creates or manufactures risk
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Beck Globalization
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globalization has unintended consequences which are translated into risk and that risk in one society is now a global issue bc we are so interconnected
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human rights
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the basic rights to which all people are entitled as human beings
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Human Rights timeline
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Magna Carta 1215
Petition of Right 1628
Declaration of Independence 1776
Declaration of Rights of Man and of the Citizen 1789
Universal Declaration of Human Rights 1948
Petition of Right 1628
Declaration of Independence 1776
Declaration of Rights of Man and of the Citizen 1789
Universal Declaration of Human Rights 1948
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Universal Declaration of Human Rights
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A 1948 statement in which the United Nations declared that all human beings have rights to life, liberty, and security.
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prevalence study
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recruits a representative sample of a population, asks them to complete a survey and uses info to get a snapshot of health status in the population at one point in time
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true or false: unemployed adults are more likely than employed adults to die from suicide
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true
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what is not included in the calculation of a country's human development index?
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unemployment rates and income disparities
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what are partial explanations for health disparities?
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chronic psychosocial stress and higher rates of poverty associated with reduced health status, different cultural practices like preferred diets
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if the rate ratio and it's 95% confidence interval for a cohort study is RR=2.0 what is the most appropriate conclusion about the association between the exposure and the disease of interest?
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the exposure is a risk factor for the disease
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true or false: the shared commitment to ensuring that everyone has the basic tools for survival and health has already been recognized in numerous international agreements
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true
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true or false: freshwater is considered to be both an essential human need and a consumer good
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true
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true or false: most people who sustain landline injuries are civilians
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true
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what framework refers to the critical service areas that require immediate attention after a disaster?
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essential support functions
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what has the aim to reduce impairment, minimize pain and suffering and prevent death in people with symptomatic health problems?
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tertiary prevention
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true or false: because some countries have gone through health transitions and other countries have not, there are now significant differences in health status in the highest income and lowest income countries
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true
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true or false: there is often considerable diversity in the socioeconomic and health profiles of countries within the same world region
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true
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the life expectancy at birth in Sierra Leone is about 38 years. what can you infer about the population of Sierra Leone?
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there are a lot of infant and child deaths in Sierra Leone
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which term is used to describe the absence or presence of illness or disease?
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morbidity
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which condition causes a higher proportion of disability-adjusted life years for females than for males?
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cancers of the reproductive system
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which condition causes a higher proportion of disability adjusted life years for males than for females?
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autism spectrum disorders
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which perspective on health blames illness on demonic possession, evil eye, or the anger of God or the gods or ancestors?
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supernatural viewpoint
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what refers to superficial categories that group individuals based primarily on physical attributes like skin color?
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race
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since the majority of people worldwide live in metropolitan areas what is a core component of global public health?
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urban health
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what has been the most important progress in health worldwide over the last 50 years?
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average life expectancy at birth increasing by 20 years; we are living longer worldwide
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are SDGs really universal and culturally relevant?
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not for the nations that are still developing and cannot make the goals of things like hunger, gender equality, and poverty in a short period of time
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in what ways has globalization impacted your health?
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the flu shot strains from asia, fruits and veggies being imported from other countries
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what population is the most vulnerable in your country?
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impoverished women, there is not currently much being done to fix this